Marie Curie Research Wing

Northwood, United Kingdom

Marie Curie Research Wing

Northwood, United Kingdom

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Ariyaratne H.,Marie Curie Research Wing | Chesham H.,Radiation Oncology Centres | Alonzi R.,Marie Curie Research Wing
British Journal of Radiology | Year: 2017

Objective: To survey the technology and practice of image-guided radiotherapy (IGRT) for prostate cancer in the UK. Methods: A pre-tested semi-structured online questionnaire was sent to National Health Service (NHS) and private radiotherapy providers in the UK between March and April 2014. The survey was carried out on the Opinio online platform. Results: There was a high survey response rate of 83%. There is widespread use of intensity-modulated radiotherapy and advanced verification imaging modalities. Cone-beam CT (CBCT) is the main verification imaging modality in radical prostate radiotherapy, used in 66% of UK centres. Fiducial markers in combination with imaging were used in 30% of centres. Over half the centres used a daily imaging schedule, with a Day 1-3 frequency followed by weekly frequency used less commonly. 26% of centres used daily CBCT. Conclusion: There is widespread use of volumetric verification imaging with CBCT for prostate radiotherapy in the UK. There is no consensus on the optimal verification imaging schedule. Advances in knowledge: This survey provides an insight into contemporary UK practice of IGRT for prostate cancer, both in the NHS and private sector. It demonstrates the widespread use of CBCT imaging and highlights the need for further research to optimize the practice. © 2016 The Authors. Published by the British Institute of Radiology.


Alonzi R.,Marie Curie Research Wing | Alonzi R.,Mount Vernon Cancer Center | Padhani A.R.,Paul Strickland Scanner Center | Taylor N.J.,Paul Strickland Scanner Center | And 5 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2011

Purpose: The antivascular effects of androgen deprivation have been investigated in animal models; however, there has been minimal investigation in human prostate cancer. This study tested the hypothesis that androgen deprivation causes significant reductions in human prostate tumor blood flow and the induction of hypoxia at a magnitude and in a time scale relevant to the neoadjuvant setting before radiotherapy. Methods and Materials: Twenty patients were examined, each with five multi-parameter magnetic resonance imaging scans: two scans before the commencement of androgen suppression, one scan after 1 month of hormone treatment, and two further scans after 3 months of therapy. Quantitative parametric maps of the prostate informing on relative blood flow (rBF), relative blood volume (rBV), vascular permeability (transfer constant [Ktrans]), leakage space (ve) and blood oxygenation (intrinsic relaxivity [R2]) were calculated. Results: Tumor blood volume and blood flow decreased by 83% and 79%, respectively, in the first month (p < 0.0001), with 74% of patients showing significant changes. The proportion of individual patients who achieved significant changes in T1 kinetic parameter values after 3 months of androgen deprivation for tumor measurements was 68% for Ktrans and 53% for ve By 3 months, significant increases in R2 had occurred in prostate tumor, with a rise of 41.1% (p < 0.0001). Conclusions: Androgen deprivation induces profound vascular collapse within 1 month of starting treatment. Increased R2 in regions of prostate cancer and a decrease in blood volume suggest a reduction in tumor oxygenation. © 2011 Elsevier Inc.


PubMed | Marie Curie Research Wing
Type: Journal Article | Journal: International journal of radiation oncology, biology, physics | Year: 2011

The antivascular effects of androgen deprivation have been investigated in animal models; however, there has been minimal investigation in human prostate cancer. This study tested the hypothesis that androgen deprivation causes significant reductions in human prostate tumor blood flow and the induction of hypoxia at a magnitude and in a time scale relevant to the neoadjuvant setting before radiotherapy.Twenty patients were examined, each with five multi-parameter magnetic resonance imaging scans: two scans before the commencement of androgen suppression, one scan after 1 month of hormone treatment, and two further scans after 3 months of therapy. Quantitative parametric maps of the prostate informing on relative blood flow (rBF), relative blood volume (rBV), vascular permeability (transfer constant [K(trans)]), leakage space (v(e)) and blood oxygenation (intrinsic relaxivity [R(2)]) were calculated.Tumor blood volume and blood flow decreased by 83% and 79%, respectively, in the first month (p < 0.0001), with 74% of patients showing significant changes. The proportion of individual patients who achieved significant changes in T1 kinetic parameter values after 3 months of androgen deprivation for tumor measurements was 68% for K(trans) and 53% for v(e) By 3 months, significant increases in R(2) had occurred in prostate tumor, with a rise of 41.1% (p < 0.0001).Androgen deprivation induces profound vascular collapse within 1 month of starting treatment. Increased R(2) in regions of prostate cancer and a decrease in blood volume suggest a reduction in tumor oxygenation.

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